PD46-02 INITIAL CLINICAL EXPERIENCE WITH PERCUTANEOUS IRREVERSIBLE ELECTROPORATION OF RENAL TUMORS

Abstract

You have accessJournal of UrologyKidney Cancer: Localized: Ablative Therapy & Active Surveillance1 Apr 2016PD46-02 INITIAL CLINICAL EXPERIENCE WITH PERCUTANEOUS IRREVERSIBLE ELECTROPORATION OF RENAL TUMORS Noah Canvasser, Aaron Lay, Monica Morgan, Asim Ozayar, Jeffrey Gahan, Clayton Trimmer, and Jeffrey Cadeddu Noah CanvasserNoah Canvasser More articles by this author , Aaron LayAaron Lay More articles by this author , Monica MorganMonica Morgan More articles by this author , Asim OzayarAsim Ozayar More articles by this author , Jeffrey GahanJeffrey Gahan More articles by this author , Clayton TrimmerClayton Trimmer More articles by this author , and Jeffrey CadedduJeffrey Cadeddu More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2016.02.2394AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Percutaneous irreversible electroporation (IRE) is a novel minimally invasive technique to treat small renal tumors. IRE uses an electric field to create nano-pores within cellular membranes resulting in subsequent apoptosis. Because IRE is athermal, it offers potential advantages to radiofrequency (RFA) and cryoablation. We evaluated our initial experience to assess feasibility, safety, effectiveness, and radiographic outcomes of IRE renal tumor ablation. METHODS We retrospectively reviewed all IRE cases completed at our institution from April 2013-July 2015. IRE was performed using the NanoKnife® commercial system and 15 cm monopolar probes (AngioDynamics, NY, USA). All procedures were performed with computed tomography (CT) guidance, under general anesthesia with paralytics, and with ablation synchronized to the cardiac cycle. A minimum of six weeks of follow-up with a contrast-enhanced CT scan was necessary to be included in the analysis. RESULTS A total of 32 tumors were treated with IRE, with median follow up of 10 months (range 1-27 months). Patient and tumor characteristics are shown in table 1. CT scan immediately post procedure typically showed decreased perfusion with an enhancing rim at the ablation site. Patients were discharged the same day in 20 of 32 (63%) cases, while the remainder were discharged on the first post-operative day. There were no complications. At six weeks, three patients (9.4%) had persistent rim enhancement on CT scan, indicating ablation failure. These patients underwent successful salvage RFA and remain disease free. Of 21 patients with at least six months of follow up, one patient (4.8%) had a recurrence that was treated with successful partial nephrectomy. CONCLUSIONS Percutaneous IRE of renal tumors is feasible and safe. Nephron-sparing techniques remain a viable salvage option in patients who fail IRE. Further follow-up is needed to demonstrate long-term oncologic efficacy. © 2016FiguresReferencesRelatedDetails Volume 195Issue 4SApril 2016Page: e1123 Advertisement Copyright & Permissions© 2016MetricsAuthor Information Noah Canvasser More articles by this author Aaron Lay More articles by this author Monica Morgan More articles by this author Asim Ozayar More articles by this author Jeffrey Gahan More articles by this author Clayton Trimmer More articles by this author Jeffrey Cadeddu More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...